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Transrectal ultrasound guided (TRUS) biopsy

Doctors use this test to diagnose prostate cancer. They take samples of tissue from the prostate gland to look for cancer cells.

You might have an MRI scan before your transrectal ultrasound guided biopsy.

What it is

This is a type of needle biopsy to look for cancer cells in the prostate. Your doctor takes a series of small tissue samples from the prostate to examine under a microscope.

You usually have the biopsy through your back passage (rectum) using a transrectal ultrasound scanner.

Preparing for your TRUS biopsy

You have the biopsy in the outpatient department.

Your nurse will ask you to sign a consent form once they have given you information about the procedure.

You take antibiotics to stop infection developing after the biopsy. You have a dose of antibiotics before the biopsy, and then for a couple of days afterwards.

Eating and drinking and medicines

You usually have a TRUS biopsy under local anaesthetic, so you can generally eat and drink normally beforehand.

Take your usual medicines as normal, unless your doctor tells you otherwise. But if you take warfarin to thin your blood you should stop this before you have your biopsy. Your doctor will tell you when you need to stop taking it.

What happens

In the biopsy room

Before you have the biopsy, your doctor shows you the ultrasound machine and the very fine needle they use to take the tissue samples. The needle attaches to a firing mechanism. It makes quite a loud noise, so it’s good to expect this. The doctor will explain the whole procedure before they start and you can ask any questions you need to.

During the biopsy

First, you lie down on your left side. Your specialist injects local anaesthetic into your back passage (rectum), to numb the area. It makes the procedure as painless as possible.

The doctor puts an ultrasound probe into your rectum to examine your prostate. To get the samples of prostate tissue, they push the fine needle along the ultrasound probe and into the prostate gland.

This is a little uncomfortable, and might be painful but doesn’t take long. You feel a slight jolt each time the doctor fires the needle.

This might happen up to 12 times as the doctor takes the different tissue samples. The whole procedure takes about 20 minutes.

Diagram showing a guided biopsy of the prostate.jpg

After the biopsy

After the test, you have a rest and a drink. You can then go home.

The team monitors you for at least 30 minutes afterwards.

It is very important to drink a lot of fluids for the next 24 hours.

Side effects

Your prostate gland will bleed. And there is a risk of urine infection. Drinking plenty of fluid flushes out the blood and helps to stop you getting any infection. You will see blood in your urine, back passage and semen for a few weeks, but it won’t harm you.

Phone your doctor straight away or go to the accident and emergency department (A&E) if you have signs of infection, such as:
  • shivering or shaking
  • a high temperature
  • a lot of difficulty passing urine
  • a need to pass urine very often
  • a lot of blood in your urine or poo

You need to have antibiotics straight away if you have a urine infection.

Possible risks

This test is a safe procedure but there are some possible risks.

These are:
  • ongoing bleeding
  • infection
  • pain
  • not getting enough biopsy samples

Your doctor or nurse explain these when you sign your consent form. Ask them any questions you have about the possible risks.

Getting your results

Waiting for test results can be a very worrying time. You can contact your specialist nurse if you are finding it hard to cope. You can also get in touch with them to ask for information if you need to. It can also help to talk to a close friend or relative about how you feel.

For support and information, you can call the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.

Information and help

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